OBJECTIVES: Research into emotional or behavioral stress typically focuses upon the hypothalamic-pituitary-adrenal axis. It is well established that the hypothalamic-pituitary-adrenocortical axis is subject to inhibitory control by opioids in a variety of animal species including pigs. Exposure to acute stress induces the upregulation of opioid receptors and the release of endogenous peptides which mediate the stress-induced analgesia. There is some literature substantiating that repeated stress can lead to changes in opioidergic neurotransmission. However, the changes are highly variable. This study was designed to observe the modulatory effect of repeated immobilization stress on opioidergic neurotransmission. METHODS: Male Sprague-Dawley rats weighing 150-200g were forced to suffer immobilization stress for 2 hours on each of 14 successive days. Then we examined the maximum binding capacity and affinity of each opioid subtypes(mu, delta, kappa). RESULTS: Repeated immobilization stress increased the binding of [3H]DPDPE on the delta-subtype opioid receptor in the striatum and hypothalamus. Saturation experiments followed by scatchard analyses of the results showed an increase in the density of delta-subtype opioid receptors, but the affinity of the delta-subtype opioid receptor remained unchanged. Repeated immobilization stress reduced enkephalin activity of striatum and hypothalamus. CONCLUSIONS: From these results, it could be concluded that repeated immobilization stress up-regulated the delta-subtype opioid receptors and reduced the activity of enkephalin, an endogenous ligand for the delta-subtype opioid receptor.
Analgesia ; Analgesics, Opioid ; Animals ; Axis, Cervical Vertebra ; Enkephalins ; Humans ; Hypothalamus ; Immobilization ; Male ; Peptides ; Rats* ; Rats, Sprague-Dawley ; Receptors, Opioid ; Swine ; Synaptic Transmission* ; Up-Regulation

PURPOSE: The purpose of this study was to verify the effect of aromatherapy massage on constipation in the elderly. METHOD: This study for 10 day, employed a randomized control group pretest-posttest design. The experimental group received abdominal massage using essential oils with Rosemary, Lemon, and Peppermint, and the control group received a placebo massage. To evaluate the effect of aromatherapy, the degree of constipation was measured using the CAS(constipation assessment scale) and the number of bowel movements per week. Data was analyzed by repeated measures of ANOVA using the SPSS program. RESULT: The score of CAS of the experimental group was significantly lower than that of the control group. In addition the average number of bowel movements in the experimental group was higher than that of the control group. The effect of aromatherapy lasted 2 weeks after treatment, while the placebo effect lasted 7~10 days after treatment. CONCLUSION: The finding of this study showed that aromatherapy helps relieve constipation in the elderly.
Plant Oils/therapeutic use ; Oils, Volatile/*therapeutic use ; *Massage ; Male ; Humans ; Female ; Constipation/*therapy ; *Aromatherapy ; Aged, 80 and over ; Aged

OBJECTIVES: Generally, major depressive disorder (MDD) with psychiatric comorbidities is associated with a high suicide rate. However, this relationship has not been studied much in Korea. In this study, we evaluated the suicidality in MDD with psychiatric comorbidities. METHODS: This study was performed on patients who visited the psychiatric department of three university hospitals in the Gyeongbuk area from March 2008 to September 2011. In total, 776 patients were evaluated with the Mini-International Neuropsychiatric Interview-Plus (MINI-Plus), and 288 with MDD were recruited for the study. Suicidality and suicidal risks were evaluated in the MINI-Plus questionnaire. RESULTS: MDD patients with comorbidities had a significantly higher suicidality and suicidal risk than patients with pure MDD. Suicidality was significantly higher in an anxiety disorder group with comorbidity than in the pure MDD group. As the total number of comorbidities got higher, the suicidality increased, and suicidal risks had significant differences depending on the total number of comorbidities. CONCLUSION: These results suggest that an MDD patient with comorbidities has a higher suicidality and suicidal risk. In clinical settings, comorbid MDD patients should be approached with more aggressive psychiatric intervention of their suicidal thoughts and actions.
Anxiety Disorders ; Comorbidity ; Depressive Disorder, Major ; Hospitals, University ; Humans ; Korea ; Suicide

Septooptic dysplasia is a rare anterior midline anomaly considered to be a mild form of lobar holoprosencephaly. We describe a case with unilateral optic nerve hypoplasia and the absence of a septum pellucidum.
Holoprosencephaly ; Optic Nerve ; Septo-Optic Dysplasia* ; Septum Pellucidum

OBJECTIVE: This study explored the development of metabolic syndrome, changes in body weight and metabolic syndrome parameters (waist circumference, serum glucose and lipids, blood pressure), and effects of psychotropic agents in psychiatric inpatients being treated with psychotropic agents. METHODS: In all, 146 patients who had been admitted to a psychiatric isolated ward for more than 1 month between August 2012 and May 2014 were included in this study. During hospitalization, levels of triglyceride, high density lipoprotein-cholesterol (HDL), low density lipoprotein-cholesterol, and serum glucose, and blood pressure, height, body weight, and waist circumference were regularly measured. For obtaining data on laboratory tests, physical examination and demographic and clinical characteristics, we reviewed patients' medical records. RESULTS: After using psychotropic agents for 3 months, body mass index increased significantly and HDL levels decreased significantly. Of 119 patients without metabolic syndrome at baseline, 15 (12.61%) patients developed a this syndrome after 3 months. Among psychotropic agents, quetiapine most largely increased the number of patients who meet the criteria for metabolic syndrome (17.9%), and this change was significantly larger than that of aripiprazole (p=0.031). Carbamazepine significantly increased waist circumference. Duloxetine and lamotrigine significantly increased triglyceride levels. Olanzapine, aripiprazole, mirtazapine, duloxetine and valproic acid significantly decreased HDL levels. Futher, olanzapine and valproic acid significantly increased body mass index. Fluoxetine significantly decreased body mass index. CONCLUSION: The results of this study indicate that at least 1 in 10 patients using psychotropic agents develop metabolic syndrome within a relatively short time; this finding emphasizes the importance of early diagnosis and treatment. Because abnormality of lipid parameters was prominent in early phase of treatment, clinicians should monitor these levels carefully. In addition, some psychotropic agents could affect body weight and metabolic syndrome parameters and thus clinicians should be aware of this changes in patients using psychotropic agents. Main limitation of this study is high drop-out rate (74%), and this could make the result underestimate.
Blood Glucose ; Blood Pressure ; Body Height ; Body Mass Index ; Body Weight* ; Carbamazepine ; Early Diagnosis ; Fluoxetine ; Hospitalization ; Humans ; Inpatients* ; Medical Records ; Physical Examination ; Triglycerides ; Valproic Acid ; Waist Circumference ; Aripiprazole ; Duloxetine Hydrochloride ; Quetiapine Fumarate

OBJECTIVE: The purpose of this investigation was to identify distinctive clinical correlates of psychotic major depression (PMD) as compared with non-psychotic major depression (NPMD) in a large cohort of Korean patients with major depressive disorder (MDD). METHODS: We recruited 966 MDD patients of age over 18 years from the Clinical Research Center for Depression of South Korea (CRESCEND) study. Diagnoses of PMD (n=24) and NPMD (n=942) were made with the DSM-IV definitions and confirmed with SCID. Psychometric scales were used to assess overall psychiatric symptoms (BPRS), depression (HAMD), anxiety (HAMA), global severity (CGI-S), suicidal ideation (SSI-Beck), functioning (SOFAS), and quality of life (WHOQOL-BREF). Using independent t-tests and chi2 tests, we compared clinical characteristics of patients with PMD and NPMD. A binary logistic regression model was constructed to identify factors independently associated with increased likelihood of PMD. RESULTS: PMD subjects were characterized by a higher rate of inpatient enrollment, and higher scores on many items on BPRS (somatic concern, anxiety, emotional withdrawal, guilt feelings, tension, depression, suspiciousness, hallucination, motor retardation, blunted affect and excitement) global severity (CGI-s), and suicidal ideation (SSI-Beck). The explanatory factor model revealed that high levels of tension, excitement, and suicidal ideation were associated with increased likelihood of PMD. CONCLUSION: Our findings partly support the view that PMD has its own distinctive clinical manifestation and course, and may be considered a diagnostic entity separate from NPMD.
Anxiety ; Cohort Studies ; Depression* ; Depressive Disorder, Major ; Diagnosis ; Diagnostic and Statistical Manual of Mental Disorders ; Guilt ; Hallucinations ; Humans ; Inpatients ; Korea ; Logistic Models ; Psychometrics ; Quality of Life ; Suicidal Ideation ; Weights and Measures

A cross-sectional study was performed to evaluate the effects of chronic exposure to low-dose solvent on neurobehavioral performance of 48 male workers exposed to organic solvents. A control group of 50 workers was selected from same factories. Each worker completed a medical and occupational questionnaire and four tests of Neurobehavioral Core Test Battery. These included Benton visual retention test, digit symbol, digit span, and pursuit aiming. Comparison of mean performance showed a significantly poorer performance on digit symbol, digit span, and pursuit aiming. In univariate analysis, age contributed to poor performance on Benton visual retention test and educational level was found to reduce the performance on symbol digit in both groups. Amount of alcohol intake was found to reduce the performance on digit symbol and smoking appeared to slow pursuit aiming in the exposure group. In multiple regression analysis, controlling for age, educational level, alcohol, and smoking, solvent exposure was found to be associated with performance of digit span, and number of correct dot of pursuit aiming. Age on Benton visual retention, educational level on digit symbol, and smoking on pursuit aiming were found to be a significant factors on each test items. This study suggest that short-term memory, and perception can be affected easily by chronic exposure of organic solvents which air concentration level were under the Threshold Limit Value.
Cross-Sectional Studies ; Humans ; Male ; Memory, Short-Term ; Surveys and Questionnaires ; Smoke ; Smoking ; Solvents*

We aimed to examine the potential relationship between season of birth (SOB) and clinical characteristics in Korean patients with unipolar non-psychotic major depressive disorder (MDD). Using data from the Clinical Research Center for Depression (CRESCEND) study in South Korea, 891 MDD patients were divided into two groups, those born in spring/summer (n=457) and those born in autumn/winter (n=434). Measurement tools comprising the Hamilton Depression Rating Scale, Hamilton Anxiety Rating Scale, Brief Psychiatric Rating Scale, Scale for Suicidal Ideation, Clinical Global Impression of severity, Social and Occupation Functional Assessment Scale, WHO Quality of Life assessment instrument-abbreviated version, Alcohol Use Disorder Identification Test, and Temperament and Character Inventory were used to evaluate depression, anxiety, overall symptoms, suicidal ideation, global severity, social function, quality of life, drinking, and temperament and character, respectively. Using independent t-tests for continuous variables and χ2 tests for discrete variables, the clinical characteristics of the two groups were compared. MDD patients born in spring/summer were on average younger at onset of first depressive episode (t=2.084, p=0.038), had greater loss of concentration (χ2=4.589, p=0.032), and were more self-directed (t=2.256, p=0.025) than those born in autumn/winter. Clinically, there was a trend for the MDD patients born in spring/summer to display the contradictory characteristics of more severe clinical course and less illness burden; this may have been partly due to a paradoxical effect of the 5-HT system.
Adult ; Age of Onset ; Aged ; Alcohol Drinking ; Bipolar Disorder/*diagnosis/*ethnology/psychology ; Character ; Cost of Illness ; Depression ; Depressive Disorder, Major/*diagnosis/*ethnology/psychology ; Female ; Humans ; Male ; Middle Aged ; Personality Inventory/statistics & numerical data ; *Quality of Life ; Republic of Korea/epidemiology ; *Seasons ; Temperament

OBJECTIVES: An exact diagnosis and comorbidity analysis are important in psychiatric disorders. The Psychiatric Diagnostic Screening Questionnaire (PDSQ) is both useful as a self-reporting test for screening psychiatric disorders and available for clinical settings due to its simplicity and convenience. This study, as a part of standardization of Korean version of Psychiatric Diagnostic Screening Questionnaire (K-PDSQ), evaluated optimal cutoff scores. METHODS: The samples were 696 patients in total, who were selected from the psychiatric departments of 3 university hospitals from March 2008 to August 2011. Diagnosing by Mini-International Neuropsychiatric Interview-Plus (MINI-Plus), we evaluated sensitivity, specificity, cutoff scores, ROC curve, and area under the curve (AUC) of K-PDSQ. SPSS version 12.0 for Windows and MedCalc version 12.0 were used to analyze the results. RESULTS: With a cutoff score of 9 for major depressive disorder in K-PDSQ, both the sensitivity and specificity were 80%. The cutoff scores of PTSD, OCD, panic disorder, agoraphobia, psychosis, alcohol related problem, GAD, hypochondriasis, and social phobia of K-PDSQ were 5, 2, 4, 2, 1, 2, 5, 4, and 5, respectively. In most of the subscales, each AUC was above 0.75. CONCLUSION: By applying the cutoff scores estimated above, we expect K-PDSQ to help provide diagnostic assessments and to grasp comorbidities before a clinical interview in the setting of busy outpatient clinics.
Agoraphobia ; Ambulatory Care Facilities ; Area Under Curve ; Comorbidity ; Depressive Disorder, Major ; Hand Strength ; Hospitals, University ; Humans ; Hypochondriasis ; Mass Screening ; Panic Disorder ; Phobic Disorders ; Psychotic Disorders ; Surveys and Questionnaires ; ROC Curve ; Sensitivity and Specificity ; Stress Disorders, Post-Traumatic

OBJECTIVES: The aim of this study is to develop guideline for evaluation of depression. METHODS: Development of this guideline was processed according to the ADAPTE manual, which was developed for adaptation of good clinical practice guidelines. Important key questions were determined, and a systematic review of clinical practice guidelines was performed. The contents of guidelines selected by comparison of the methodological quality and currency were evaluated with regard to the applicability and acceptability. Answers to key questions and clinical recommendations were established by peer review. RESULTS: Careful evaluations on the characteristics of depression, including subtype, severity, suicidality, and psychiatric and physical comorbidities were recommended because these factors can have an influence on course and prognosis in treatment of depression. CONCLUSION: The results of this study may contribute to the systematic evaluation of depression, based on clinical importance. However, this guideline did not include systematic reviews regarding useful scales for evaluation of depression. In the future, amendment of this guideline might be needed in order to supplement limitations.
Comorbidity ; Depression* ; Depressive Disorder ; Diagnosis* ; Methods ; Peer Review ; Prognosis ; Weights and Measures